背景:特发性正常压力脑积水(iNPH)是一种影响老年人的慢性疾病。它的特征是症状和放射学发现的三合会。青光眼是全球不可逆失明的主要原因。早期的研究表明,iNPH患者的青光眼发病率较高,以及脑室腹腔分流术(VP)治疗与青光眼发展之间的可能联系。
目的:本研究旨在确定iNPH患者中青光眼的患病率,并评估VPs对青光眼患病率的影响。
方法:在库奥皮奥大学医院(KUH)进行了一项队列研究,包括262例脑室-腹腔分流术患者.临床数据来自KuopioNPH注册和医疗记录。患者按iNPH状态分组:iNPH(+)-可能/可能的iNPH(n=192),和iNPH(-)-脑积水的其他原因(先天性,次要,阻塞性)(n=70)。我们使用独立样本T检验进行了统计分析,费希尔的精确检验,和PearsonChi-Square.我们比较了人口统计,青光眼患病率,对淀粉样蛋白β(Aβ)和高磷酸化tau(HPτ)以及高血压和糖尿病药物合并症的脑活检呈阳性。年龄分层评估全队列中的青光眼患病率。
结果:iNPH(+)组和iNPH(-)组具有相当的人口统计学和合并症特征。iNPH(+)组青光眼患病率为11.5%(n=22),iNPH(-)组为11.4%(n=8),差异无统计学意义(p=1.000)。淀粉样蛋白β(Aβ)和高磷酸化tau(HPτ)阳性的脑活检相似。
结论:除iNPH外,分流的iNPH患者和合并疾病的患者均未显示出明显较高的青光眼患病率。相反,两组均表现出年龄相关的青光眼患病率增加,与基于人群的研究中观察到的趋势相似。我们的数据并未表明VP分流与青光眼发生率升高之间存在相关性。
BACKGROUND: Idiopathic Normal Pressure Hydrocephalus (iNPH) is a chronic condition affecting the elderly. It is characterized by a triad of symptoms and radiological findings. Glaucoma is the leading cause of irreversible blindness worldwide. Earlier studies have proposed that the rate of glaucoma is higher in iNPH patients, and of a possible link between ventriculoperitoneal shunt (VP) treatment and the development of glaucoma.
OBJECTIVE: This study aimed to determine the prevalence of glaucoma among iNPH patients and assess the impact of VPs on glaucoma prevalence.
METHODS: A cohort study was conducted at Kuopio University Hospital (KUH), including 262 patients with a ventriculoperitoneal shunt. Clinical data were obtained from the Kuopio NPH Registry and medical records. Patients were grouped by iNPH status: iNPH (+) - probable/possible iNPH (n = 192), and iNPH (-) - other causes of hydrocephalus (congenital, secondary, obstructive) (n = 70). We conducted statistical analysis using the Independent Samples T-test, Fisher\'s exact test, and Pearson Chi-Square. We compared demographics, glaucoma prevalence, brain biopsies positive for Amyloid-β (Aβ) and hyperphosphorylated tau (HPτ) as well as comorbidities for hypertension and diabetes medication. Age stratification assessed glaucoma prevalence in the full cohort.
RESULTS: Both iNPH (+) and iNPH (-) groups had comparable demographic and comorbidity profiles. The prevalence of glaucoma in the iNPH (+) group was 11.5% (n = 22) and 11.4% (n = 8) in the iNPH (-) group without a statistically significant difference (p = 1.000). Brain biopsies positive for Amyloid-β (Aβ) and hyperphosphorylated tau (HPτ) were similar.
CONCLUSIONS: Neither shunted iNPH patients nor those with a comorbid condition other than iNPH showed a markedly higher prevalence of glaucoma. Instead, both groups exhibited age-related increases in glaucoma prevalence, similar to the trends observed in population-based studies. Our data does not suggest a correlation between VP shunts and an elevated rate of glaucoma.